ABSTRACT
To study the outcome of treatment, and epidemiology of burn injuries in Ahvaz, Iran. This retrospective study analyzed the epidemiology, mortality rate, etiological factors among 11492 patients admitted in burn-care centre in Ahvaz Iran. The influence of modifications made on building facilities, instruments and techniques implemented during 9 years [1999-2007] on the rate of mortality was also evaluated for the burn centre serving four provinces 6T Iran: Khuzestan, Elam, Lorestan and Bushher. The hospitalized patients in less than 15 years old age group accounted for 32.4%. The highest number of admitted cases [40%] had their ages ranging between 16 to 30 years and the lowest [3.7%] had ages more than 60 years. The mean age and mean total burn surface area [TBSA] were 22.4 years and 38.4% respectively. Most accidents were caused by flame [60%]. The proportion of males was 55.6%, while higher TBSA burns were seen in females [66.2%]. Overall mortality was 16.06% [range 23.8 in 1999 to 14.8% in 2007]. Most burn injuries occurred in winter season [31.9%], predominantly accidentally [83.8%], at home [64%] and among urban dwellers [86%]. There was a general reduction in the trend of mortality rate from 19.7% in year 2001 to 14.8% in year 2007. This trend was correlated with application of amniotic membrane in 2002, use of early excision, early grafting techniques in 2004, improvement in building facilities such as use of separate departments for infected and non-infected cases, establishment of an ICU in 2005 and use of laser therapy with CO[2] in 2005. The findings suggest that the phenomenon of burn injury is serious problem in this area which calls for careful planning both in community, educational and training of medical staff
Subject(s)
Humans , Male , Female , Burns/epidemiology , Treatment Outcome , Retrospective Studies , Burns/mortality , Burns/etiology , HospitalizationABSTRACT
The main aim of this study was to evaluate how much of the surrounding area need to be resected to reach tumor free margin in cases of recurrent Squamous Cell Carcinoma [SCC] Marjolin ulcer. The other objective was to report the demographic characteristics, the site of development of SCC Marjolin ulcers. A total of 266 patients with ulcers created on burn scars were studied. Biopsy samples were taken from all ulcers and evaluated pathologically for chronic inflammation or SCC Marjolin ulcer. For primary SCC Marjolin ulcers a 2cm safety margin was removed, while for recurrent SCC Marjolin ulcers a 2cm safety margin was removed and assessed pathologically under frozen-section and a further 0.5cm safety margin was removed in cases of SCC involvement in any of the planes of the resected sections for reaching a SCC-clear margin. One hundred eighteen of the cases were due to chronic inflammation, and the remaining 148 cases were due to SCC Marjolin ulcers. Of this 31 cases were recurrent ones. At least one site of all the recurrent SCC Marjolin ulcer samples were found to be involved and required a second resection attempt for reaching a clear and a safe margin. Although classically 2cm safety margin is still widely used for resection of primary SCC Marjolin ulcers, we recommend that a 2.5cm safety margin is better for resection in recurrent cases
ABSTRACT
There are several advantages with use of contour threads in the face lifting technique These include no need for incision, so there is no scar lines, there is no damage to facial nerve, use of local anaesthesia is sufficient to produce analgesia, therefore it makes the procedure a very safe operation for elderly, diabetic and cardiopulmonary patients, and do not cause hair loss. In addition, the patients are awake and can chose the desired extent of final face lifting. We present the technique of use of contour threads and the outcome of a case of forehead/brow lifting in a 42 years old insulin-dependent diabetic single man who suffered from sagged eyebrows and many wrinkles on the lateral canthos of the eye. He did not have any cardiopulmonary or vascular disorders